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Vol. 3, No. 3, 2011
Issue release date: September – December
Section title: Published: November 2011
Open Access Gateway
Case Rep Dermatol 2011;3:251–258
(DOI:10.1159/000334734)

A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin

Suzuki M.a–c · Yoshizawa A.a · Sugiyama H.a · Ichimura Y.a · Morita A.a · Takasaki J.a · Naka G.a · Hirano S.a · Izumi S.a · Takeda Y.a · Hoji M.a · Kobayashi N.a · Kudo K.a
aDepartment of Respiratory Medicine, National Center for Global Health and Medicine, and bInternal Medicine, Department of Pulmonary Medicine, Infection, Oncology, Nippon Medical School, Tokyo, and cBioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
email Corresponding Author

Abstract

An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS). She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS), based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM)] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.

© 2011 S. Karger AG, Basel


  

Key Words

  • Nail discoloration
  • Yellow nail syndrome
  • Sinobronchial syndrome
  • Clarithromycin

  

Author Contacts

Manabu Suzuki, MD
Bioscience Medical Research CenterNiigata University Medical and Dental Hospital
1-754, Asahimachi-dori, Chuo-ku, Niigata 951-8520 (Japan)
Tel. +81 25 227 2022, E-Mail manabu@nms.ac.jp

  

Article Information

Published online: November 30, 2011
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 1,

  

Publication Details

Case Reports in Dermatology

Vol. 3, No. 3, Year 2011 (Cover Date: September - December)

Journal Editor: Jemec G.B.E. (Roskilde)
ISSN: NIL (Print), eISSN: 1662-6567 (Online)

For additional information: http://www.karger.com/CDE


Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS). She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS), based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM)] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.

© 2011 S. Karger AG, Basel


  

Author Contacts

Manabu Suzuki, MD
Bioscience Medical Research CenterNiigata University Medical and Dental Hospital
1-754, Asahimachi-dori, Chuo-ku, Niigata 951-8520 (Japan)
Tel. +81 25 227 2022, E-Mail manabu@nms.ac.jp

  

Article Information

Published online: November 30, 2011
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 1,

  

Publication Details

Case Reports in Dermatology

Vol. 3, No. 3, Year 2011 (Cover Date: September - December)

Journal Editor: Jemec G.B.E. (Roskilde)
ISSN: NIL (Print), eISSN: 1662-6567 (Online)

For additional information: http://www.karger.com/CDE


Article / Publication Details

First-Page Preview
Abstract of Published: November 2011

Published online: 11/30/2011
Issue release date: September – December

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 1

ISSN: (Print)
eISSN: 1662-6567 (Online)

For additional information: http://www.karger.com/CDE


Open Access License / Drug Dosage

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.